New Patient Information

New Patients

Thank you for choosing The Plastic Surgery of Westchester! In preparation for your first visit, we kindly ask that you complete the new patient forms and bring them with you to your appointment (demographic form, HIPAA release, assignment of benefits, health history, pharmacy information, photo/video consent, and Covid-19 consent). We are located at 500 Mamaroneck Avenue in Harrison, NY 10528. Our office (Suite 211) is located at the South entrance of the building. Upon arrival, please wait in your car and call us at 914-771-7373 to confirm we are ready to welcome you in. Note: Due to Covid-19, you may be required to enter through the main entrance at the back of the building and check in with security. Contactless temperatures will be taken as you walk into the office.

Due to the new Government issued medical guidelines in regards to COVID-19, the following rules and regulations also must be followed:

Isolate yourself 5 days before visit.
Only one guest is allowed with you to the appointment, although we would greatly appreciate it if you came alone.
Please arrive 10-15 minutes before appointment and call upon arrival. Remain in your vehicle until directed to come in.
ALL patients and staff members MUST wear a face mask/ face covering.

Please see the following COVID 19 related symptoms below. If you have been out of the country in the past 14 days, have experienced any of these symptoms, or were in contact with anyone who has tested positive in the past 2 weeks, please notify us in advance!

Symptoms include:

Cough
Shortness of breath or difficulty breathing
Fever
Chills
Sore throat
Muscle pain
New loss of taste or smell
Rash
Any GI issues (nausea, vomiting, or diarrhea)

We look forward to seeing you and thank you for your patience and cooperation as we work to keep everyone safe and healthy!

New Patient Information.

New Patients

New Patient Registration Form

Medical Photo/Video Release Form

Pharmacy Form

COVID19 Informed Consent Form